Sleeping poorly? If you’re an older man, that could mean you’re more likely to commit suicide

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Robin Williams’ death has sparked an intense—and welcome—discussion on the connections between depression and suicide. Now, a Stanford University study points to a more unexpected link to suicide among older men: the lack of sleep.

The study by Rebecca Bernert, an expert on sleep medicine and mental health, suggests that, independent of depressive symptoms, senior citizens who sleep poorly have a 1.4 times greater chance of death by suicide than those who get lots of z’s.

Bernert’s researchers interviewed and collected data from 14,456 participants in the US between the ages of 66-90, at six time points over a 10-year period. The majority of participants were white (58.3%), followed by African American (19.3%), and other (1.2%). Interviews evaluated the person’s depression symptoms, sleep quality, cognitive and physical functions, and vital statistics. Over that period, 21 people—20 of whom completed all interviews and were thus counted in the study—committed suicide; 19 of them were male. Researchers compared them and 400 others in a control group to determine what factors could be linked to greater suicide risk.

What they found was that those who reported poorer sleep quality had a significant risk for death by suicide. On average they scored higher than the control group in following categories:

difficulty falling asleep

difficulty staying asleep

waking up early in the mornings

being sleepy during the day

having non-restorative sleep

It’s important to note, that even though those who died by suicide averaged higher scores than the control group in all these categories, only two (difficulty falling asleep, and having non-restorative sleep) showed actual statistical significance—which is to say the scores were much higher. The last category, having non-restorative sleep, was statistically significant in its association with greater risk of suicide even when depressive symptoms were factored out.

“Disturbed sleep stands apart as a risk factor and warning sign in that it may be undone, which highlights its importance as a screening tool and potential treatment target in suicide prevention,” Bernert said in the press release. Opportunities for screening may actually be plentiful: among elder men who commit suicide, 45% visit their physicians in the final week—73% in the final month.